Effects of opium inhalation on pulmonary volumes in smoking patients

Historically, opium was used as a potent analgesic and to treat dyspnea and cough. It is documented that opium can increase exercise tolerance and relieve breathlessness. However, its overdose can suppress respiratory centers. The purpose of this study was to evaluate effects of opium on spirometric lung volumes. The study was done on two groups of patients referred to the lung clinic of Labbafi Nejad hospital. Group A was composed of 84 patients who were smokers and group B was made up of 40 patients who were smokers and opium addicts. Patients underwent spirometry and demographic questionnaires were collected. Significant differences were noted on lung volumes between two groups. Forced Vital Capacity [FVC] was 56 +/- 4.6 % in Group A and 72 +/- 4.7 % in Group B [P < 0.001]. Difference on Forced Expiratory Volume in one second [FEV1] was also statistically significant, 53 +/- 6.6 % in Group A versus 69 +/- 4.4 % in Group B [P < 0.001]. In this study, lung volumes were considerably larger in patients who were opium addicts and smokers compared to patients who were only smokers. Further studies are warranted to confirm these results, and such confirmation may lead to better understanding about role of opioids in respiratory diseases

Serum troponin levels, APACHE II score and mortality rate for non-cardiac reasons in RCU patients

Estimating the severity of disease and prognosis for patients hospitalized in intensive care units may be important in selection of diagnostic procedures and treatment regimens. For this purpose, various ranking methods have been used in these units which have their benefits and shortcomings. n this study, all patients admitted to the respiratory intensive care unit [RCU] of Labbafi Nejad Hospital during the year 2005 with no signs of cardiac disease or history of cardiopulmonary resuscitation were evaluated. All patients had their serum troponin level checked in the first hour of hospitalization in the unit and upon first medical examination acute physiologic and chronic health evaluation [APACHE] II scores were determined for them. In total, 87 patients were eligible for entering the study. There were significant correlations between serum troponin levels and APACHE II score [p=0.0001]. There was also a significant correlation between elevated troponin levels and mortality rate. Multivariate statistical analysis showed that APACHE II scores and serum troponin levels each are independent variables affecting prognosis among hospitalized patients in the respiratory intensive care unit. Determination of serum troponin levels in non-cardiac patients admitted to respiratory intensive care unit can be a helpful prognostic factor

Study on the hypatotoxicity of anti-tuberculosis drugs in 190 patients with pulmonary and extrapulmonary tuberculosis

Tuberculosis is one of the oldest diseases that affect humans. The cause of this disease is Mycobacterium tuberculosis. This disease affects approximately 8.8 million people worldwide and led to over 3 million deaths in 1995. 95% of those affected and 98% of deaths occurred in developing countries. Hepatic reactions constitute a major proportion of drug reactions to antituberculosis drugs being reported in 4% of cases treated with rifampinlisoniazid and pyrazinamide in the USA and 8-50% in India and developing countries. For the purpose of identifying the hepatotoxicity of anti-tuberculous drugs, this study was performed in hospitals affiliated to Shahid Beheshti University in Tehran during 1994 to 1997. The current descriptive study was performed on hospitalized patients diagnosed as having active tuberculosis. History was taken from all the patients and clinical signs were recorded. Three sputum samples for mycobacterial acid fast stain examination and cultures [three consecutive days] were sent to Pasteur Institute. Liver function tests [AST, ALT, alkaline phosphatase, bilirubin, PT] were performed before treatment and repeated weekly for two weeks then two weekly for the first two months and then monthly until the end of treatment. From a total of 262 patients during the study, 190 patients were studied. 51% were male and the rest were females. The lowest rate of TB was in the age group less than 5 and the most frequent rate of TB was in the 56-65 years age group. 107 patients [56.2%] had active pulmonary tuberculosis and 43.7% had extra-pulmonary TB. 44.2% had positive smear sputum, 22.1% had positive biopsy, and 33.6% were diagnosed based on clinical findings, x-rays and other paraclinical tests. 25.7% of patients had increased ALT and AST following the treatment, and in 4.7% of cases the increase was 4-5 times normal and in 3.6% 5 times normal, 8.4% had increase in bilirubin and 6.8% had increase in bilirubin associated with increase in ALT and AST, 8.4% had increased alkaline phosphatase and 7.6% had disturbance in PT. Considering that 25.7% of the patients had increased levels of liver enzymes and in 3.6% of them the increased level exceeded 5 times that of normal and also 6 cases of 7 were over 35 years old, therefore, anti-tuberculosis drug consumption, must be considered more seriously in patients over the age of 35

Intrathoracic kidney: a CT-scanning view

We report a patient who was admitted to the department of medicine with palpitation, dyspnea and left flank pain. Chest X-ray revealed a mass in the left lung. The lesion was evaluated as a pulmonary tumor, with a high suspicion of malignancy. Intravenous urography, sonography, and CT- scanning revealed a thoracic kidney at the location previously thought to be a lung mass. This is the first report of a CT-scanning evaluation of thoracic kidney

Late complications of sulfur mustard in respiratory system

In the last few years many chemically injured patients have been visited throughout the country in order to investigate the late respiratory complications of sulfur mustard. 35 patients who were previously admitted for mustard poisoning underwent complete clinical examination as well as spirometry, fiberoptic bronchoscopy [FOB], Bronchoalveolar lavage [BAL], and transbronchial lung biopsy [TBLB]. The results of this study reveal a high incidence of air flow obstruction in these patients [50%]. BAL shows decreased numbers of macrophages and increased numbers of lymphocytes and neutrophils, and the presence of eosinophils [between 1 to 5%]. Certain pathologic features have been encountered. We conclude that late respiratory complications of sulfur mustard are major causes of morbidity and are quite resistant to therapy